20150873 Ver 1_2015-01907 NW 14_20150916

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SAW-2015-01907 County: Alamance U.S.G.S. Quad: NC-KIMESVILLE
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Permittee: NCDOT
attn: Jerrv Parker
Address: P.O. Box 14996
Greensboro, NC 27415
Size (acres) 0_5 Nearest Town Snow Camp
Nearest Waterway UT to Little Creek River Basin Haw. North Carolina.
USGS HUC 3030002 Coordinates 35.940290 N, -79.508450 W
Location description: The site is located along SR ll10 (Mount Zion Road) over UT to Little Creek at NCDOT Bridge 200 in
Alamance Countv, North Carolina.
Description of projects area and activity: This autborization is for the discharge of clean fill material associated with replacing
an existing bridge with a 3-sided bottomless culvert. Impacts include permanent impacts to 661inear feet (0.03 acre) of stream
channel for channel reali�nment, floodplain bench construction, and bank stabilization, and temporary impacts to 23 linear
feet (0.02 acre) of stream channel for construction access and dewatering necessary to install the new structure.
Applicable Law: � Section 404 (Clean Water Act, 33 USC 1344)
❑ Section 10 (Rivers and Harbors Act, 33 USC 403)
Authorization: Regional General Permit Number or Nationwide Permit Number: NWP 14 Linear Transportation Projects.
SEE ATTACHED RGP or NWP GENERAL, REGIONAL AND SPECIAL CONDITIONS
Your work is authorized by the above referenced permit provided it is accomplished in strict accordance with the attached
conditions and your submitted application and attached information received via e-mail 8/26/2015. Any violation of the
attached conditions or deviation from your submitted plans may subject the permittee to a stop work order, a restoration
order, a Class I administrative penalty, and/or appropriate legal action.
This verification will remain valid until tbe expiration date identified below unless ihe nationwide authorization is modified,
suspended or revoked. If, prior to the expiration date identified below, the nationwide permit authorization is reissued and/or
modified, this verification will remain valid until the expiration date identified below, provided it complies with all requirements of
the modified nationwide permit. If the nationwide permit authorization expires or is suspended, revoked, or is modified, such that the
activity would no longer comply with the terms and conditions of the narionwide permit, acrivities which have commenced (i.e., are
under construction) or are under contract to commence in reliance upon the nationwide permit, will remain authorized provided the
activity is completed within twelve months of the date of the nationwide permit's expiration, modification or revocation, unless
discrctionary authority has been exercised on a case-by-case basis to modify, suspcnd or revoke the authorization.
Activities subject to Section 404 (as indicated above) may also require an individual Section 401 Water Quality Cerrification. You
should contact the NC Division of Water Quality (telephone 9] 9-807-6300) to determine Section 401 requirements.
For activities occurring within the twenry coastal counties subject to regulation under the Coastal Area Management Act (CAMA),
priar to beginning work you must contact the N.C. Division of Coastal Management.
This Department of the Army verification does not relieve the permittee of the responsibility to obtain any other required Federal,
State or local approvals/permits.
If there are any questions regarding this verification, any of the conditions of the Permit, or the Corps of Engineers regulatory
program, please contact David Bailey at 919-554-4884 ext. 30 or David.E.Bailey2(�usace.armv.mil.
Di9i��ally zigned by
� BAILEY.DAVID.E.13J9283J36
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CO�c TP��I��O� 0��..r��l. � <n=BFlILEVDAVIDEI3)9283/36 Date: 9/16/2015
J K� � t;� � oa�e�.zoisos.isosos:a�-oa�oo�
Expiration Date of Verification: 03/18/2017
Copy furnished:
Dave Wanucha, NCDENR-DWR, 450 W. Hanes Mill Rd, Suite 300, Winston Salem NC 27105

SAW-20l 5-01791
Special Conditions:
In order to compensate for impacts associated with this permit, mitigation shall be provided in
accordance with the provisions outlined on the most recent version of the attached Compensatory
Mitigation Responsibility Transfer Form. The requirements of this form, including any special
conditions listed on this form, are hereby incorporated as special conditions of this permit authorization.
2. This USACE permit does not authorize you to take a threatened or endangered species, in particular, the
Northern Long-eared Bat (NLEB) (Myotis septentrionalis). In order to legally take a listed species, you
must have separate authorization under the Endangered Species Act (ESA) (e.g., a Biological Opinion
(BO) under the ESA, Section 7, with "incidental talce" provisions with which you must comply). The
U.S. Fish and Wildlife Service's (USFWS's) Programmatic BO titled "Northern Long-eared Bat
(NLEB) Programmatic Biological Opinion for North Carolina Department of Transportation (NCDOT)
Activities in Eastern North Carolina (Divisions 1-8)," dated March 25, 2015, and adopted on May 4,
2015, contains mandatory terms and conditions to implement the reasonable and prudent measures that
are associated with "incidental take" that are specified in the BO. Your authorization under this USACE
permit is conditioned upon your compliance with all the mandatory terms and conditions (incorporated
by reference into this permit) associated with incidental take of the BO. Failure to comply with the terms
and conditions associated with incidental take of the BO, where a talce of the listed species occurs,
would constitute an unauthorized take, and would also constitute non-compliance with your USACE
permit. The USFWS is the appropriate authority to determine compliance with the terms and conditions
of its BO and with the ESA.
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Corps Regulatory Official:
Expiration Date of Verification: 03/18/2017
Date: 9/16/2015

U.S. ARMY CORPS OF ENGINEERS
Wilmington District
Compensatorv Miti�ation Responsibilitv Transfer Form
Permittee: NCDOT Action ID: SAW-2015-01907
Project Name: NCDOT / Replace Bridge 200 on SR 1110 / Alamance County County: Alamance
Instructions to Permittee: The Permittee must provide a copy of this form to the Mitigation Sponsor, either an approved
Mitigation Bank or the North Carolina Ecosystem Enhancement Program (NCEEP), who will then sign the form to verify the
transfer of the mitigation responsibility. Once the Sponsor has signed this form, it is the Permittee's responsibility to
ensure that to the U.S. Army Corps of Engineers (USACE) Project Manager identified on page two is in receipt of a signed
copy of this form before conducting authorized impacts, unless otherwise specified below. If more than one mitigation
Sponsor will be used to provide the mitigation associated with the permit, or if the impacts and/or the mitigation will occur
in more than one 8-digit Hydrologic Unit Code (HUC), multiple forms will be attached to the permit, and the separate forms
for each Sponsor and/or HUC must be provided to the appropriate mitigation Sponsors.
Instructions to Sponsor: The Sponsor must verify that the mitigation requirements (credits) shown below are available at
the identified site. By signing below, the Sponsor is accepting full responsibility for the identified mitigation, regardless of
whether or not they have received payment from the Permittee. Once the form is signed, the Sponsor must update the
bank ledger and provide a copy of the signed form and the updated bank ledger to the Permittee, the USACE Project
Manager, and the Wilmington District Mitigation Office (see contact information on page 2). The Sponsor must also comply
with all reporting requirements established in their authorizing instrument.
Permitted Impacts and Compensatory Mitigation Requirements:
Permitted Impacts Requiring Mitigation* 8-digit HUC and Basin: 03030002, Cape Fear River Basin
Stream Impacts (linear
Warm Cool
66
Wetland Impacts (acres
Cold I Riqarian Riverine I Rioarian Non-Riverine I Non-Riparian I Coastal
*If more than one mitigation sponsor will be used for the permit, only include impacts to be mitigated by this sponsor.
atory Mitigation Requirements
Stream Mitigation (credits)
Warm Cool Cold
66
8-dieit HUC and Basin: 03030002. Cape Fear River Basin
Wetland Mitigation (credits)
Riparian Riverine Riparian Non-Riverine Non-Riparian Coastal
Mitigation Site Debited: NCDMS (formerly NCEEP)
(List the name of the bank to be debited. For umbrella banks, also list the specific site. For NCEEP, list NCEEP. If the NCEEP
acceptance letter identifies a specific site, also list the specific site to be debited).
Section to be completed by the Mitigation Sponsor
Statement of Mitigation Liability Acceptance: I, the undersigned, verify that I am authorized to approve mitigation
transactions for the Mitigation Sponsor shown below, and I certify that the Sponsor agrees to accept full responsibility for
providing the mitigation identified in this document (see the table above), associated with the USACE Permittee and Action
ID number shown. I also verify that released credits (and/or advance credits for NCEEP), as approved by the USACE, are
currently available at the mitigation site identified above. Further, I understand that if the Sponsor fails to provide the
required compensatory mitigation, the USACE Wilmington District Engineer may pursue measures against the Sponsor to
ensure compliance associated with the mitigation requirements.
Mitigation Sponsor Name:
Name of Sponsor's Authorized Representative:
Signature of Sponsor's Authorized Representative
Date of Signature
Page 1 of 2 Form Updated 12 September, 2014

USACE Wilmington District
Compensatory Mitigation Responsibility Transfer Form, Page 2
Conditions for Transfer of Compensatory Mitigation Credit:
• Once this document has been signed by the Mitigation Sponsor and the USACE is in receipt of the signed form, the
Permittee is no longer responsible for providing the mitigation identified in this form, though the Permittee remains
responsible for any other mitigation requirements stated in the permit conditions.
• Construction within jurisdictional areas authorized by the permit identified on page one of this form can begin only
after the USACE is in receipt of a copy of this document signed by the Sponsor, confirming that the Sponsor has
accepted responsibility for providing the mitigation requirements listed herein. For authorized impacts conducted by
the North Carolina Department of Transportation (NCDOT), construction within jurisdictional areas may proceed upon
permit issuance; however, a copy of this form signed by the Sponsor must be provided to the USACE within 30 days of
permit issuance. NCDOT remains fully responsible for the mitigation until the USACE has received this form, confirming
that the Sponsor has accepted responsibility for providing the mitigation requirements listed herein.
• Signed copies of this document must be retained by the Permittee, Mitigation Sponsor, and in the USACE
administrative records for both the permit and the Bank/ILF Instrument. It is the Permittee's responsibility to ensure
that the USACE Project Manager (address below) is provided with a signed copy of this form.
• If changes are proposed to the type, amount, or location of mitigation after this form has been signed and returned to
the USACE, the Sponsor must obtain case-by-case approval from the USACE Project Manager and/or North Carolina
Interagency Review Team (NCIRT). If approved, higher mitigation ratios may be applied, as per current District
guidance and a new version of this form must be completed and included in the USACE administrative records for both
the permit and the Bank/ILF Instrument.
Comments/Additional Conditions:
This form is not valid unless signed below by the USACE Project Manager and by the Mitigation Sponsor on Page 1. Once
signed, the Sponsor should provide copies of this form along with an updated bank ledger to: 1J the Permittee, 2) the
USACE Project Manager at the address below, and 3J the Wilmington District Mitigation Office, Attn: Todd Tugwell,
11405 Falls of Neuse Road, Wake Forest, NC 27587 (email: [e-mail]. Questions regarding this form
or any of the permit conditions may be directed to the USACE Project Manager below.
USACE Project Manager: David Bailey
USACE Field Office: Raleigh Regulatory Field Office
US Army Corps of Engineers
3331 Heritage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
Email: [e-mail]
_ Digitally signed by BAILEY.DAVID.E.1379283736
� DN: c=US, o=U.S. Government, ou=DoD, ou=PKl,
ou=USA, cn=BAILEY.DAVID.E.1379283736
Date: 2015.09.16 08:07:17 -04'00'
September 16, 2015
USACE Project Manager Signature Date of Signature
Current Wilmington District mitigation guidance, including information on mitigation ratios, functional assessments, and
mitigation bank location and availability, and credit classifications (including stream temperature and wetland groupings) is
available at http://ribits.usace.armv.mil.
Page 2 of 2
The Wilmington District is committed to providing the highest level of support to the public. To help us ensure we continue to do so, please complete the
Customer Satisfaction Survey located at our website at http://regulatorv.usacesurvey.com/ to complete the survey online.

Determination of Jurisdiction:
A. ❑ Based on preliminary information, there appear to be waters of the US including wetlands within the above described project
area. This preliminary determination is not an appealable action under the Regulatory Program Administrative Appeal Process
( Reference 33 CFR Part 331).
B. ❑ There are Navigable Waters of the United States within the above described project area subject to the permit requirements of
Section 10 of the Rivers and Harbors Act and Section 404 of the Clean WaYer Act. Unless there is a change in the law or our
published regulations, this determination may be relied upon for a period not to exceed five years from the date of this
notification.
C. � There are waters of the US and/or wetlands within the above described project area subject to the perinit requirements of
Section 404 of the Clean Water Act (CWA)(33 USC § 1344). Unless there is a change in the law ar our published regulations,
this determination may be relied upon for a period not to exceed five years from the date of this notification.
D. ❑ The jurisdictional areas within the above described project area have been identified under a previous action. Please reference
jurisdictional determination issued . Action ID: SAW- .
Bas1s FOt' Detet'minatiOn: The site exhibits feaYures with Ordinarv Hi�h R'ater. The waters on site include UT to Little
Creek - a tributary (AS water) that flows via Little Creek, South Prong Stinking Quarter Creek, and Stinkin� Quarter Creek
to Big Alamance Creek, a Traditionally Navigable Water (A1 water). This determination is based on an office veri6cation bv
David E. Bailev (USACE) on 9/16/2015.
Remarks:
E. Attention USDA Program Participants
This delineation/determination has been conducted to identify the limits of Corps' Clean Water Act jurisdiction for the particular site
identified in this request. The delineation/determination may not be valid for the wetland conservation provisions of the Food Securiry
Act of 1985. If you or your tenant are USDA Program participants, or anticipate participation in USDA programs, you should request
a certified wetland detennination from the local office of the Natural Resources Conservation Service, prior to starting work.
F. Appeal5 Informati0n (This information applies only to approved jurisdictional determinations as indicated in B
and C above).
This correspondence constitutes an approved jurisdictional determination for the above described site. If you object to this
determinarion, you may request an administrarive appea] under Corps regulations at 33 CFR Part 331. Enclosed you will find a
Notificarion of Appeal Process (NAP) fact sheet and request for appeal (RFA) form. If you request to appeal this determination you
must submit a coinpleted RFA form to the following address:
US Army Corps of Engineers
South Atlantic Division
Attn: Jason Steele, Review Officer
60 Forsyth Street SW, Room 1OM15
Atlanta, Georgia 30303-8801
Phone: [phone]
In order for an RFA to be accepted by the Corps, the Corps must determine that it is complete, that it meets the criteria for appeal
under 33 CFR part 331.5, and that it has been received by the Division Office within 60 days of the date of the NAP. Should you
decide to submit an RFA form, it must be received at the above address by 11/15/2015.
**It is not necessary to submit an RFA form to the Division Office if you do not object to the determination in this correspondence.**
� Digitally signed by BAILEY.DAVID.E.1379253736
�� DN: r—U5, o=U.S. Govemment, ou=DOD, ou=PKl,
ou=USA, cn=BAILEY.DAVID.E.1379283736
Corps Regulatory Official: �ace:zois.o9.ieos:o�:s4-o4o0�
David E. Bailey
Date of JD: 9/16/2015 Expiration Date of JD: 9/16/2020

NOTIFICATION OF ADMINISTRATIVE APPEAL OPTIONS AND PROCESS AND
REQUEST FOR APPEAL
NCDOT File Number: SAW-2015-01907 Date: 9/16/2015
Attached is:
❑ INITIAL PROFFERED PERMIT Standard Permit or Letter of permissi
n PROFFERED PERMIT (Standard Permit or Letter of permissionl
PERMTT DENIAL
APPROVED JURISDICTIONAL DETERMINATION
PRELiMINARY JURiSDICTIONAL DETERMINATION
See Section below
�
C
0
0
0
SECTION I- The following identifies your rights and options regarding an administrative appeal of the above decision.
Additional information may be found at or http://www.usace.at7l�y.mil/Missions/CivilWorlcs/Regulator_���ranlandPei7nits.aspx
ar the Coms re�ularions at 33 CFR Part 331.
A: INITIAL PROFFERED PERMIT: You may accept or object to the permit.
• ACCEPT: If you received a Standard Permit, you inay sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is autharized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its ierms and conditions, and approved jurisdictional determinations associated with the
permit.
OBJECT: If you object to the permit (Standard ar LOP) because of certain terms and conditions therein, you may request
that the permit be modified accordingly. You must complete Section II of this form and return the form to the district
engineer. Your objections must be received by the district engineer within 60 days of the date of this notice, or yon will
forfeit your right to appeal the permit in the future. Upon receipt of your letter, the district engineer will evaluate your
objections and may: (a) modify the permit to address all of your concerns, (b) modify the permit to address some of your
objections, or (c) not modify the permit having determined that the permit should be issued as previously written. After
evaluating your objections, the district engineer will send you a proffered permit for your reconsideration, as indicated in
Section B below.
B: PROFFERED PERMIT: You may accept or appeal the permit
• ACCEPT: If you received a Standard Permit, you may sign the permit docwnent and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your worlc is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appea] the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
• APPEAL: If you choose to decline the proffered permit (Standard or LOP) because of certain tenns and conditions therein,
you may appeal ihe declined permit under the Corps of Engineers Administrative Appeal Process by completing Section II of
this form and sending the form to the division engineer. This form must be received by the division engineer within 60 days
of the date of this notice.
C: PERMIT DENIAL: You may appeal the denial of a pennit under the Corps of Engineers Administrative Appeal Process by
complering Section II of this form and sending the form to the division engineer. This form must be received by the division
engineer within 60 days of the date of this norice.
D: APPROVED JURISDICTIONAL DETERMINATION: You may accept or appeal the approved JD or provide new
information.
ACCEPT: You do not need to notify the Corps to accept an approved JD. Failure to notify the Coips within 60 days of the
date of this notice, means that you accept the approved JD in its entirety, and waive all rights to appeal the approved JD.
• APPEAL: If you disagree with the approved JD, you may appeal the approved JD under the Corps of Engineers
Administrative Appeal Process by completing Section II of this fonn and sending the form to the district engineer. This form
�nust be received by the division engineer within 60 days of the date of this notice.

E: PRELIMINARY JURISDICTIONAL DETERMINATION: You do not need to respond to the Corps regarding the
preliminary JD. The Preliminary JD is not appealable. If you wish, you may request an approved JD (which may be appealed),
by contacting the Corps district for further instruction. Also you may provide new information for further consideration by the
Corps to reevaluate the JD.
SECTION II - REQUEST FOR APPEAL or OBJECTIONS TO AN INITIAL PROFFERED PERMIT
R�ASONS FOR APPEAL OR OBJECTIONS: (Describe your reasons far appealing the decision or your objections to an initial
proffered pennit in clear concise statements. You may attach additiona] information to this form to clarify where your reasons or
objections are addressed in the administrative record.)
ADDITIONAL INFORMATION: The appeal is limited to a review of the administrative record, the Corps memorandum for the
record of the appeal conference or meeting, and any supplemental information that the review officer has determined is needed to
clarify the administrative record. Neither the appellant nor the Corps may add new information or analyses to the record.
However, you inay provide additional information to clarify the location of information that is already in the administrative
record.
POINT OF CONTACT FOR QUESTIONS OR INFORMATION:
If yoLi have questions regarding this decision and/or the If you only have questions regarding the appea] process you may
appeal process you may contact: also contact:
District Engineer, Wilmington Regulatory Division, Attn: Mr. Jason Steele, Administrative Appeal Review Officer
attn: David Bailey CESAD-PDO
Raleigh Regulatory Field Office U.S. Army Corps of Engineers, South Atlantic Division
3331 Heritage Trade Drive, Suite 105 60 Forsyth Street, Room 1OM15
Wake Forest, North Carolina 27587 Atlanta, Georgia 30303-8801
Phone: [phone]
RIGHT OF ENTRY: Your signature below grants the right of entry to Corps of Engineers personnel, and any government
consultants, to conduct investigations of the project site during the course of the appeal process. You will be provided a 15 day
notice of any site investi ation, and will have the o ortunity to partici ate in all site investi ations.
Date: Telephone number:
Signature of a pellant or agent.
For appeals on Initial Proffered Permits send this form to:
District Engineer, Wilmington Regulatory Division, attn: David Bailey, 69 Darlington Avenue, Wilmington, North Carolina
28403
For Permit denials, Proffered Permits and approved Jurisdictional Determinations send this form to:
Division Engineer, Commander, U.S. Army Engineer Division, South Atlantic, attn: Mr. Jason Steele, Administrative Appeal
Ofticer, CESAD-PDO, 60 Forsyth Street, Room 1OM15, Atlanta, Georgia 30303-8801
Phone: [phone]

Action ID Number: SAW-2015-01907 County: Alamance
Permittee: NCDOT (attn: Jerrv Parker)
Project Name: NCDOT / SR 1110 / Bridge 200 / Division 7/ Alamance Countv
Date Verification Issued: 9/16/2015
Project Manager: David Bailev
Upon completion of the activity authorized by this permit and any mitigation required by the permit,
sign this certification and return it to the following address:
US ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
attn: David Bailey
Raleigh Regulatory Field Office
3331 Heritage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
Please note that your permitted activity is subject to a compliance inspection by a U. S. Army Corps of
Engineers representative. Failure to comply with any terms or conditions of this authorization may
result in the Corps suspending, modifying or revoking the authorization and/or issuing a Class I
administrative penalty, or initiating other appropriate legal action.
I hereby certify that the work authorized by the above referenced permit has been completed in
accordance with the terms and condition of the said permit, and required mitigation was completed in
accordance with the permit conditions.
Signature of Permittee Date